When a medical emergency strikes, a sudden fall, a deep cut, or a collapse — the first few minutes can make all the difference. Doctors often call this window the ‘golden hour’, the crucial period when timely action can save a life or prevent lasting damage.
Knowing what to do and what not to do before professional help arrives is often the thin line between recovery and tragedy.
The first rule in such scenarios, according to emergency specialists, is to stay calm and ensure the environment is safe especially in case of accidents. “Before rushing to help, look around to check for traffic, fire, live wires, unstable surfaces,” says Shruthi Degapudi , neurologist at Prashanth Hospitals. Once safety is ensured, check the person’s responsiveness. Speak to them, gently tap their shoulder, and see if they respond. If the person is not breathing and has no pulse, begin CPR if trained to do so. If they are unconscious but breathing, place them in the recovery position, lying on their side with the head slightly tilted back, and wait for emergency services. Never pour water, force food or medicine into their mouth, and avoid moving them unless there is immediate danger.
Falls, bleeding and burns
Falls and collapses are among the most common emergencies at home and in public spaces. In such moments, experts advise against hurriedly lifting or shaking the person awake. “If the person has hit their head or you suspect a spinal injury, keep the head and neck aligned and do not attempt to move them,” says Krithika P., consultant in paediatric intensive care at Rainbow Children’s Hospitals, Chennai. A simple fainting spell, however, can often be managed by laying the person flat and raising their legs slightly to improve blood flow to the brain. If the collapse is accompanied by loss of consciousness or abnormal breathing, emergency help must be called for at once. “When in doubt, treat every fall with caution,” adds Viju Wilben, clinical lead and consultant, emergency department, at Narayana Health City, Bengaluru.
When faced with bleeding, the most important step is to apply firm, direct pressure over the wound using a clean cloth or gauze. “Pressure stops bleeding more effectively than anything else,” says S. Hariprasad, consultant in emergency medicine and critical care, SRM Global Hospitals. Elevating the injured part, if possible, helps reduce blood flow to the area.
If an object is embedded in the wound, it should not be removed; pressure should instead be applied around it. Dressings once applied should not be peeled off even if soaked; new layers must be added on top. Rinsing with clean water is acceptable, but antiseptics, powders or traditional home remedies should be avoided.
In cases of burns, experts emphasise the importance of immediate cooling under clean running water for 10 to 20 minutes. “The idea is to stop the burning process and reduce tissue damage,” explains L. V. Lakshminarayanan, orthopaedic surgeon at VS Hospitals, Chennai. Any jewellery or tight clothing near the burn should be gently removed unless stuck to the skin.
Butter, toothpaste, ghee or oil should never be applied — they trap heat and worsen the injury. Once cooled, the area should be loosely covered with a clean, non-stick cloth, and medical attention sought if the burn is large, deep, or involves the face or joints.
Severe allergic reactions
Anaphylaxis, a severe allergic reaction, can develop within seconds. Swelling of the lips, tongue, or face, difficulty breathing, and collapse after food, insect bites, or medication are key signs. “Delaying adrenaline administration can be fatal,” says Ajay Christopher, in-charge, emergency medicine, Rela Hospital, Chennai. If available, an epinephrine auto-injector should be used immediately, and help must be sought without delay.
The person should be kept lying flat with their legs raised unless their breathing is severely compromised. Oral medicines or fluids must never be given during distress. Even if symptoms ease, observation at a hospital is essential as reactions can recur.
When someone is choking but still able to cough or speak, encourage them to keep coughing ; this may expel the obstruction. If they cannot breathe or make any sound, alternate between back blows and abdominal thrusts in adults, or back blows and chest thrusts for infants. “Never insert your fingers blindly into the mouth — you might push the object in deeper,” says Dr Krithika. If the person becomes unresponsive, start CPR immediately.
Strokes, heart attacks and seizures
In both strokes and heart attacks, time is critical. For strokes, doctors use the mnemonic FAST — Face drooping, Arm weakness, Speech difficulty, Time to act fast. “Sometimes we add Balance and Eyes to make it BE-FAST,” says Rammohan K. R., clinical coordinator, emergency medicine at MGM Healthcare, Chennai. Sudden dizziness, vision problems, or slurred speech all warrant an emergency call.
Heart attacks often present as chest heaviness radiating to the arm, jaw, or back, with sweating or shortness of breath. “Never drive yourself to hospital during a suspected attack,” cautions Dr. Viju Wilben. Calling an ambulance ensures immediate monitoring. If not allergic and previously advised by a doctor, the person may chew a single aspirin tablet while waiting for help.
During seizures, move away sharp objects and place something soft under the head. Do not restrain the person’s movements or insert anything between the teeth. “Time the seizure; if it lasts more than five minutes, call emergency services,” says Dr Rammohan. Once the jerking stops, roll the person to their side to keep the airway clear and wait until they are fully conscious before giving food or water.
Stabilise, not treat
While these steps can prevent harm, doctors stress that they do not replace medical care. “Your role is to stabilise, not to treat,” says Dr. Shruthi. “Do no harm– that is the principle that guides every first response.”
Every home, school, and workplace should have a visible emergency plan and a stocked first-aid kit. Knowing where emergency numbers (108 or 112) are displayed, and ensuring at least one person is trained in CPR and choking response, can save precious minutes. “Emergencies do not announce themselves, but readiness can change the outcome,” adds Dr Viju Wilben.
When the unexpected happens, quick action often determine survival. Recognising danger, calling for help, and knowing the few simple steps that can protect and comfort someone until professional care arrives — that is the essence of the golden hour.
